Although weight gain and obesity are nearly universal features of Cushings syndrome, we hypothesized that screening results would have poor specificity in an obese population. The study is based in a weight loss clinic and enrolls individuals with at least two additional signs or symptoms of Cushings syndrome. Preliminary analysis suggests a high rate (nearly 20%) of falsely positive screening tests in patients who are found to be normal on subsequent confirmatory testing. If confirmed after further study, these results suggest that current recommendations for screening may need revision.